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Chinese Consumers’ Perceptions of Functional Foods Designed to Help the Immune System Recover from the Impact of Air Pollution
No full textThe deterioration of air quality in China has resulted in many people looking for technological approaches or medical remedies to counteract the impact that air pollution is perceived to be having on their health and wellbeing. As the importance of diet on immune health is becoming increasingly well recognised, there is increasing interest in the development of food products designed to help the immune system recover from the impact of air pollution. To support the successful development of new functional foods it is vital to understand the consumers in the target market.
The overall aim of this thesis research was to investigate Chinese consumers’ perceptions of functional foods designed to help the immune system recover from the impact of air pollution. A combination of consumer research techniques was employed in four studies. Firstly, a narrative literature review (Study 1) was conducted to elucidate Chinese consumers’ acceptance and market potential of functional food products designed to help the immune system recover from the impact of air pollution. Consumers’ attitudes towards functional foods including those designed to enhance the immune system were mainly positive, with scientific validation being important in determining the credibility of a product. This was despite the fact that the effectiveness of products currently in the market, purported to be remedies for pollution-driven impacts on the lung, did not appear to be supported by scientific evidence. The lack of scientific validation for such products was interesting as numerous studies have reported on compounds originating from food that appear to provide a wide range of benefits to immune health, including helping pollution-driven immune issues. Review of the literature showed what would appear to be market demand for effective and scientifically-proven functional food products that help Chinese consumers’ immune system recover from the impact of air pollution.
Further, a netnography study (Study 2) was conducted to explore consumers’ understanding of the impact of air pollution on their health, and key attributes (expected benefits, forms and patterns of consumption) they desire in functional foods designed to help the immune system cope with the impact of air pollution. The impact of pollution on the respiratory system was considered to be of the most concern and homemade Traditional Chinese Medicine therapies and diet adjustment were the main forms of remedies discussed online. Most of the network users who posted comments were living in the East of China, which is the most economically developed area and one of the areas that suffer the most air pollution. Consumers in these areas are also generally well educated, have higher incomes, are more likely to have been exposed to Western concepts, brands etc., and are more open to trying novel foods from overseas countries than consumers in other parts of China. Therefore, the following studies chose participants having a middle-upper income and living in Shanghai or Suzhou, which are two of the most developed cities in East China.
Focusing on immune health, a study (Study 3) using focus groups (n=4) and in-home semi-structured interviews (n=12) was conducted to investigate consumers’ views and living experiences of coping with poor immunity, especially under polluted air, and to obtain an understanding of the links individuals were making between their immune health and food choice. Participants tended to use the phrase “immunity” in reference to their immune system and the overall role and importance of immunity in their daily life was widely agreed upon. A spectrum of health issues was believed to be caused by poor immunity, ranging from the common cold or flu through to cancer. Among the range of perceived reasons of poor immunity, the most common reasons given were an irregular lifestyle, exposure to polluted air and increasing age. Many participates believed that immunity could be changed by modifying what they were consuming.
The final research study (Study 4) was focused on exploring ideal product attributes consumers require in functional food products designed to combat the adverse impact of air pollution via Consumer Idealised Design (CID) workshops (n=4), each involving ten participants. Over the course of workshops, participants designed nineteen products including nine supplement-based and ten conventional-food-based designs. A tablet was the most common format in the supplement designs and the majority of conventional-foods were designed as a snack, drink, or dairy option. Participants favoured using terms such as “boosting immunity” as a health claim when products designed to be used long term and terms such as the “relieve respiratory symptoms” to promote products designed for acute use. Supplements and conventional-format functional foods were perceived differently by consumers and had differing expected health benefits and target markets. Consumers’ high attention to food safety suggested that product producers should apply multi-methods to communicate the safety of their products to consumers, such as using ingredients or processing products from authorised countries, applying authentications or scientific reports, and utilising natural ingredients rather than synthetic ones.
The results from the series of studies presented in this thesis have revealed that there is a strong potential for the increased use of functional foods to help combat the effects of air pollution in China and the innovators should develop products based on a good understanding of the unique perceptions of Chinese consumers. In addition, this research has demonstrated the advantages of using a range of consumer-oriented methodologies to obtain an understanding of targeted consumers’ perceptions when undertaking new product development. The insights gained in this thesis indicate an exciting time ahead for manufacturers of functional foods for the Chinese market
The influence of aspects of the biophysical environment on ovarian cancer cell behaviour
No full textIt has been increasingly acknowledged that the extracellular physical environment plays a vital role in cancer development and progression. However, the precise mechanisms of how the biophysical extracellular environment regulates the cancer cell responses is still not known. Here, the effects of the biophysical extracellular environment on fundamental aspects of cancer cell behaviour were studied using cell culture models.
A bioimprint cell culture model was developed in our laboratory to provide substrates with cell-like topographical features in order to decipher cellular responses specifically associated with the biophysical environment. The cells were cultured on substrates of two different topographies, a negative replica (concave) and a positive replica (convex) of a monolayer of cells, and also on a flat substrate. Three ovarian cancer cell lines representing distinct ovarian cancer subtypes were investigated. Thus, the cells were cultured in a similar biochemical milieu but in three distinct physical environments, and cell behaviour including cell morphology, protein expression, proliferation and chemosensitivity were investigated.
The results from this work demonstrated that substrate bioimprinted topography negatively regulated cell spreading, whereas it positively upregulated fibrillar protrusion numbers. Results also implicated topography-mediated increased focal adhesion and Rho signalling that was associated with the upregulated growth observed on the bioimprinted substrates. One of the important findings from this study was the reduced chemosensitivity on the bioimprinted substrates, compared to cells on the flat substrate, particularly to carboplatin rather than to paclitaxel. Inhibition of focal adhesion signalling restored platinum sensitivity on the bioimprinted substrates. Later experiments indicated the involvement of upregulated mitogen-activated protein kinase (MAPK) pathway in the altered drug sensitivities. Thus, the work using bioimprinted substrates highlighted the importance of biophysical environment in cancer cell behaviour.
With the thought that collagen is a dominant matrisomal protein, and is an important element in the framework of the extracellular environment, the collagen morphology in commercially obtained normal and cancerous ovarian tissue was investigated. A histochemical study revealed the presence of homogenously abundant thin collagen fibrils in the normal ovarian tissue, in contrast to less abundant, heterogeneously thick collagen fibres in the cancerous ovarian tissue. This altered collagen architecture may provide biophysical signals distinct from those provided by the normal collagen fibrils and thereby regulate tumour progression via mechanotransduction-associated pathways. Furthermore, ovarian tumour tissues displayed higher expression of p-FAK and p190RhoGEF, suggesting there was upregulated focal adhesion and Rho/ROCK signalling in ovarian tumours, especially in high-grade tumours.
To add further information to the notion that, as an element of the biophysical extracellular environment, collagen architecture modulates disease progression, the behaviour of ovarian cancer cells cultured in four different collagen gels was investigated. A model in which cells were cultured in disrupted collagen was developed. Collagen architecture was altered using matrix metalloproteinase (MMP1). The disrupted collagen cell culture model provided 3D biomechanical cues to the encapsulated ovarian cancer cells. The results from this work supported the speculation that collagen architecture influences ovarian cancer cell proliferation. Also, growth responses to the inhibition of focal adhesion and Rho signalling was altered, which indicated the involvement of these pathways in the biomechanical modulation of cell growth associated with collagen architecture. Further, the findings from this work indicated that collagen disruption reduced sensitivity to carboplatin, whereas paclitaxel sensitivity was not significantly affected. This is consistent with the significantly reduced carboplatin sensitivity on the bioimprinted substrates. This implies that biophysical modulation of chemosensitivity is a selective process.
Thus, the study provided evidence that the biophysical environment modulates ovarian cancer cell responses
Regulation of DEPTOR Ubiquitination by Uric Acid in the Pancreatic β-Cell
No full textAs rates of non-communicable disease such as diabetes mellitus raise the questions regarding how these diseases arise becomes more pertinent. One of the major causes of these types of disease is the effects of the modern diet which is typically high in nutrients including sugars, fats, purines and salt. Of these nutrients, the effects of high purines have been underrepresented in the current body of research. Increased dietary purines result in a commensurate increase in the synthesis of uric acid elevating serum uric acid level. This increase induces hyperuricemia and has been correlated through epidemiological studies to the development and progression of degenerative diseases including diabetes mellitus.
In an attempt to shed light on the mechanism that underpins this effect we have elected to investigate the effects of hyperuricemic conditions on the viability and growth of pancreatic β-cells through the use of live cell assays to evaluate: cellular metabolism, cell count, autophagy, and apoptosis. To explain any changes in pancreatic β-cell viability and proliferation, we also investigated how the stability of a cellular growth and viability regulating protein, DEPTOR, may change under hyperuricemic conditions. We did this by directly measuring DEPTOR-bound ubiquitin though the use of co-immunoprecipitation. To explain any observed changes in DEPTOR ubiquitination we also investigated the expression of proteins responsible for DEPTOR ubiquitination, β-TrCP, and DEPTOR deubiquitination, USP3. Finally, we investigated if there was any direct interaction between DEPTOR and uric acid using co-immunoprecipitation to test for any potential bound uric acid as it may provide insights into any changes in DEPTOR ubiquitination, β-TrCP expression, or USP3 expression.
As a result of this investigation, we found that hyperuricemic conditions are sufficient to cause significant reductions in pancreatic β-cell metabolism and cell mass and a significant increase in iii
autophagy and apoptosis. This was paired with an increase in DEPTOR stability arising from the observed reduction in DEPTOR-bound ubiquitin. This reduction in DEPTOR-bound ubiquitin was caused by a significant shift in the expression of β-TrCP and USP3 which resulted in a net shift in the balance if ubiquitination to favour the removal of ubiquitin over its binding. Additionally, our attempts to probe for potential DEPTOR-bound uric acid were successful and found that uric acid did in fact bind to DEPTOR and that this binding may explain what initiated the shifted balance of DEPTOR ubiquitination.
These results have presented some interesting questions as they are the first to indicate: uric acid is capable of modifying DEPTOR ubiquitination, USP3 was identified as a new major regulator of DEPTOR stability within the pancreatic β-cell, uric acid as a possible new regulator of cell function that has as yet gone unnoticed, and finally the differences between mouse and human responses to hyperuricemia may provide new insights into the potential mechanism that underpins uric acid’s role in the regulation of ubiquitination.
In summary, in our attempts to better understand the causes of uric acid driven increases in diabetes mellitus risk we have found that hyperuricemic conditions are sufficient to reduce the function and mass of pancreatic β-cells and that this effect is caused by a previously undescribed uric acid-driven change in regulatory protein levels
Acute cognitive effects of different glycaemic responses in healthy adults
No full textBackground: The primary fuel for the brain is glucose derived from the systemic circulation. This has led to the hypothesis that blood glucose concentration can influence cognitive performance. However, the existing literature is inconsistent, which may be caused not only by the heterogeneity in study designs but by uncontrolled confounding factors. More work with better control of confounding is warranted.
Objective: To compare the effects of different glycaemic responses, induced by beverages with different energy contents (sucrose and sucralose) and beverages with different glycaemic index (GI) (sucrose and isomaltulose) on memory and attention in healthy adults.
Design: Randomized, double-blinded, crossover, controlled trial.
Methods: A sensory test (n=11) was conducted to match the sweetness of sucrose and sucralose drinks. Glycaemic responses to sucrose and isomaltulose ingestion were measured (n=12; mean age 28.4 years; mean body mass index 23.5 kg/m2) on separate days to the cognitive test days. Participants (n=55; mean age 25.5 years; mean body mass index 22.0 kg/m2) received sucrose (50g), isomaltulose (50g) and sucralose (120mg) drinks after an overnight fast on separate occasions with at least one-week interval. The Complex Figure test, the Word Recall test, the Trail Making Test Part B, and the Stroop test were administrated 60 minutes after beverage ingestion. These tests were designed to measure verbal memory (Word Recall test), visual memory (Complex Figure test), and attention (Trail Making Test Part B and Stroop test).
Results: Sensory tests indicated that the sweetness of the beverages were indistinguishable. Plasma glucose concentration 30 minutes after ingestion was significantly different between the sucrose and isomaltulose group (8.5 vs 6.4mmol/L, with a mean (95% CI) difference of 2.1 (1.1, 3.1) mmol/L). Comparing between a noncaloric (sucralose) and a caloric sweetener (sucrose), there were no significant differences in the mean (95% CI) for the following: Complex Figure test: immediate recall -0.37 (-1.44, 0.70), delayed recall -0.47 (-1.53, 0.60); Word Recall test: immediate recall 0.28 (-0.66, 1.22), delayed recall 0.30 (-0.63, 1.22); Trail Making Test Part B: completing time -2.10 (-7.26, 3.05) seconds; Stroop test: number of correct congruent responses 0.11 (-0.08, 0.30) and correct incongruent responses 0.21 (-0.47, 0.90), time used for correct congruent responses -3.63 (-26.79, 19.53) milliseconds and correct incongruent responses -7.19 (-32.01, 17.64) milliseconds. Comparing between a low GI (isomaltulose) and a medium GI sweetener (sucrose), there were no significant differences in the mean (95% CI) for the following: Complex Figure Test: immediate recall -0.81 (-1.90, 0.28), delayed recall -0.96 (-2.04, 0.11); Word Recall Test: immediate recall 0.28 (-0.67, 1.23), delayed recall 0.59 (-0.34, 1.53); Trail Making Test Part B: completing time -2.31 (-7.51, 2.89) seconds; Stroop test: number of correct congruent responses 0.04 (-0.15, 0.23) and correct incongruent responses 0.28 (-0.42, 0.97), time used for correct congruent responses -10.84 (-34.30, 12.62) milliseconds and correct incongruent responses -18.34 (-43.49, 6.80) milliseconds.
Conclusion: This study does not support the proposition that cognitive outcomes will be affected by differences in postprandial glycaemic responses
The functional role of cardiac non-neuronal cholinergic system in the diabetic heart
No full textIn type-2 diabetes mellitus (T2DM), insulin resistance and metabolic derangements reduce glucose transporter-4 (GLUT-4) expression to decrease glucose uptake, and hence the glucose oxidation in the diabetic heart. Further, the diabetic heart displays reduced basal myocardial energy status while diminished glucose oxidation further aggravates this condition in myocardial ischemia. Previous studies showed that normalization of glucose metabolism via increasing GLUT-4 expression attenuated diabetes-induced cardiac dysfunction. Cardiomyocytes possess a non-neuronal cholinergic system (NNCS) that consists of choline acetyltransferase (ChAT), choline transporter 1 (CHT1), vesicular acetylcholine transporter (VAChT), and acetylcholinesterase (AChE) to synthesize, release and degrade acetylcholine (ACh), respectively. The released ACh binds to type-2 muscarinic ACh receptor (M2AChR) and mediates pro-survival phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) /hypoxia-inducible factor1α (HIF1α) signaling cascade to promote glucose metabolism through increasing GLUT-4 expression in normoxic condition. However, the expression and function of cardiac NNCS are not known in the diabetic heart. Therefore, the main aim of this thesis was to examine the role of cardiac NNCS in the diabetic heart
Vitamin B12 intakes of vegetarian and non-vegetarian adolescent females
No full textBackground: The adoption of plant-based diets for reasons of health and sustainability is becoming increasingly popular especially among the younger generation. Indeed, reducing meat consumption has been associated with favourable health benefits; however, certain nutrients such as vitamin B12 are naturally found mostly in animal-based foods, and thus individuals who follow vegetarian eating patterns without proper planning are at risk of dietary inadequacies. Adolescence is a life stage where rapid physical and social development takes place leading to an increase in nutrient requirements alongside social pressures which can play a major role in eating behaviours. These factors can result in an unbalanced diet among adolescents. Therefore, monitoring changes in dietary patterns and assessing nutritional status of at risk life stage groups are important. To date, there is limited information on the dietary intakes of adolescent females in New Zealand, particularly among those adopting vegetarian diets.
Objective: The aim of the study was to assess the dietary intake and adequacy of vitamin B12 among a group of vegetarian and non-vegetarian adolescent females aged 15-18 years. In addition, we also explored the major food group contributors to vitamin B12 intakes among these groups of adolescents with distinct dietary patterns.
Design: This study was a cross-sectional survey in which school-based recruitment and targeted recruitment of 15-18 year old adolescent females were conducted, from 13 high schools of different deciles across New Zealand, and vegetarians and vegans in Dunedin, respectively. Questionnaires capturing information such as sociodemographic and health were completed by the participants. Anthropometric measurements for calculation of BMI, and two 24-hour diet recalls for estimation of usual intake were collected. Dietary data including energy and vitamin B12 intakes were analysed using FoodWorks – a nutrient analysis software programme using data from the New Zealand Food Composition Tables (NZFCT) – and major food group contributors of vitamin B12 intakes were ranked.
Results: In total, 251 adolescent females provided dietary intake data. Of those who participated, 36 (13%) self-identified as vegetarian with the remaining participants reporting being non-vegetarian. The majority of participants were New Zealand European and others (NZEO) and were living in low to moderate deprived areas. Two-thirds of participants were 17-18 years old and had a healthy BMI. The mean usual vitamin B12 intakes of vegetarians and non-vegetarians were 1.4 μg/day and 2.8 μg/day, respectively. The risk of inadequate vitamin B12 intake among vegetarians (74%) are higher than non-vegetarians (14%). with the prevalence of B12 inadequacy of 74% and 14%, respectively. Milk was shown to be the common major food group contributing towards the total vitamin B12 intake of vegetarians and non-vegetarians. Other major contributing food groups of vitamin B12 are savoury sauces and condiments (included yeast extract, milk/cheese sauces, mayonnaise) for vegetarians, and beef and veal for non-vegetarians.
Conclusion: In summary, adolescent females are at risk of inadequate vitamin B12 intake with vegetarians presenting with a significantly higher prevalence of inadequacy when compared with non-vegetarians. This is a concern with the increasing adoption of vegetarian eating patterns. Future research such as national nutrition surveys are needed to track dietary patterns and assess the risk of inadequate intakes as verified by appropriate biomarkers
Characterising the activity of peroxidasin in the extracellular matrix
No full textPeroxidasin is a rising star in the field of redox biology. It is a peculiar heme peroxidase that uniquely contains non-catalytic domains in addition to the peroxidase domain. Peroxidasin catalyses the formation of an unusual sulfilimine bond between methionine and hydroxylysine in the non-collagenous domain of collagen IV in the extracellular matrix (ECM). The mechanism is proposed to involve the generation of hypobromous acid (HOBr) in a rare example of an anabolic function of this powerful oxidant and destructive bactericide. Peroxidasin is implicated in many pathologies, including cardiovascular diseases, fibrosis and cancer. A lot is unknown about the exact mechanism of collagen IV cross-linking, the substrate specificity and selectivity of peroxidasin, and regulation of its activity. One of the main questions that surrounded peroxidasin since its discovery is whether it causes collateral oxidative modifications of biomolecules.
In this thesis, I investigated the selectivity and modulation of the activity of peroxidasin in the ECM. I optimised an in situ model system and confirmed the activity of peroxidasin embedded in the ECM. The results demonstrate that peroxidasin is highly efficient in cross-linking collagen IV using low concentrations of bromide and hydrogen peroxide. Peroxidasin catalyses the oxidation of exogenous NADH to bromohydrin, providing direct evidence that it generates free HOBr in the decellularised ECM. I investigated the modulation of collagen IV cross-linking by peroxidase substrates and scavengers of HOBr. Physiological levels of thiocyanate and urate modulate collagen IV cross-linking. Overall, peroxidasin shows preference for bromide over other physiological substrates, although the basis of this specificity is not yet known. Scavengers of HOBr, like methionine and glutathione are inefficient in inhibiting the sulfilimine bond in collagen IV. These observations demonstrate selectivity of the reactions of HOBr produced by peroxidasin for collagen IV cross-linking.
I investigated whether HOBr produced by peroxidasin in the ECM undergoes reactions beyond cross-linking collagen IV. I developed mass spectrometry methods to measure markers of oxidative modifications of proteins. The results show that peroxidasin indeed catalyses the formation of 3-bromotyrosine, a specific marker of the reaction of HOBr with tyrosine. The levels of 3-bromotyrosine on proteins are significantly lower when peroxidasin is inhibited or knocked out. Formation of 3-bromotyrosine is more susceptible to inhibition by thiocyanate, urate and nitrite than the cross-linking of collagen IV. These results suggest selectivity of HOBr reactions towards the deliberate sulfilimine bond formation over the presumably collateral reactions with other amino acid residues on proteins.
Taken together, the evidence I present here demonstrates that the reactions of peroxidasin in the ECM are highly specific for, but not limited to, the cross-linking of collagen IV. It strengthens the hypothesis that HOBr generated by peroxidasin is targeted towards collagen IV, though likely to diffuse a short distance in the ECM. The novel finding that peroxidasin contributes to the formation of 3-bromoytrosine on proteins brings it to the fore as an enzymatic source of oxidative modifications of proteins. It also raises more questions about the extent and effect of peroxidasin-catalysed oxidative modifications of proteins in physiology and pathology
Aspects of Reproduction in a Post-Bonamia exitiosa Epidemic Ostrea chilensis Fishery, Foveaux Strait, Southern New Zealand
No full textThe flat oyster, Ostrea chilensis, is an important cultural and commercial species in New Zealand fishing and aquaculture industries. However, natural populations and commercial operations are threatened by haplosporidian parasites in the genus Bonamia. Mass mortality from a Bonamia exitiosa infection epidemic during 1986-1992 led to a period of closure in New Zealand’s largest flat oyster fishery at Foveaux Strait, and recent infections by a new incursion of Bonamia ostreae have forced the destocking of oyster farms nationwide. Recruitment issues have also been identified as key drivers of these commercial populations, and there is a need to improve the understanding of the reproductive biology for O. chilensis. Furthermore, B. exitiosa proliferation is thought to be controlled by O. chilensis gametogenic cycle. With these key issues in mind, the present study aimed to improve the understanding of aspects of O. chilensis reproduction, patterns of B. exitiosa infection, and to compare gametogenesis processes with those observed in Foveaux Strait before the 1986 epizootic.
The gametogenic cycle, biochemical composition, and the intensity of B. exitiosa infection in Foveaux Strait O. chilensis was examined monthly at one location from July 2017 to September 2018, with spatial variation being investigated seasonally from spring 2017 to spring 2018, across five sites. Monthly histological examination of O. chilensis gonad tissue revealed that the gametogenic cycle was relatively similar to that described before bonamiasis epidemics, with the onset of a continuous spawning event beginning in spring 2017. However, there was evidence for a more female skewed sex ratio, with less than 5% purely female oysters overall described previously, while almost one quarter of all samples were exclusively female in the present study. In addition, the development of female reproductive features at smaller sizes was observed, as well as an increased component of gonadal inactivity.
Monthly examination of the total percentage protein, carbohydrate and lipid content of oysters revealed consistent seasonal patterns in the utilisation and accumulation of reserves. Carbohydrates were depleted over the winter and spring, while high concentrations persisted through summer and autumn. While proteins and lipids exhibited the opposite trend, and were accumulated through winter, peaking in spring, with extensive utilisation occurring over summer and autumn. Oysters in western Foveaux Strait may have exhibited more conservative elements in the utilisation and accumulation of biochemical components, relying more on reserves for spawning. While eastern populations were more opportunistic, relying less onbiochemical reserves during spawning, and conserving these constituents for utilisation during lean autumn and winter months.
This may have been related to differences in B. exitiosa infection, as qPCR assays of a subset of samples suggested a higher prevalence in western Foveaux Strait, and biochemical reserves were lower in infected oysters. Overall B. exitiosa prevalence was low, at 2.2%, however, the parasite tended to exhibit a preference for female oysters weakened by spawning, or by concurrent infection of the trematode Bucephalus longicornutus. This means that gametogenesis may remain largely unaffected by B. exitiosa infection, as proliferation may occur after spawning. The present study provides insights into the relationship between B. exitiosa infection and O. chilensis gonadic condition, as well as the first description of the seasonal cycle of the biochemical composition
Soil and land resources research in five S.W. Pacific nations
No full textThis work represents major contributions for understanding and managing soils in five SW Pacific Islands.
The work covers 40 years of research developing soil information systems through mapping, laboratory characterisation (physical, chemical, mineralogy); spatial analysis; developing agro-technology transfer methods; and introduction of a soil classification “language” (US Soil Taxonomy).
The information assisted governments to make sound environmental, land use, planning, and land management decisions. It was however the Soil Resource Manuals, assessment of crop suitability ratings for >50 crops, crop suitability maps, and crop gross margins for each crop and country which aided growers.
The work expanded the capacity and capability of the agricultural workforce in extension activities, through training, advisory services, and advocacy.
Ancillary research followed, i.e. reviews of rural land use and land use policies, to ensure sustainable management of national soil resources.
The research culminated in publication of 57 research papers and 22 books and scientific reports
Effects of a Novel Massage Treatment for Chronic Low Back Pain
No full textBackground and Objectives: Gravity Relief Mobilisation is a novel manual therapy treatment for persistent musculoskeletal pain. It involves the facilitation of a non-volitional movement response. In the massage practice of the researcher, GRM appeared to have short–term benefit for musculoskeletal pain after transient increases of pain but its lasting effects were unknown.
Aim: To evaluate if GRM is an effective component of a massage therapy intervention for chronic low back pain (CLBP).
Method: Five individuals with CLBP were recruited into a concurrent series of Single Case Experiments (SCEs). Participants were randomized to a baseline (control) phase of 3-7 weeks then crossed into a 13–14 week intervention phase with 10–13 treatments. Ecological Momentary Assessments (EMA) were completed by the participants using an on line tool called the PainQuILT identifying low back pain (LBP) locations, pain intensity of LBP locations, and pain interference. EMAs were completed at a similar time of day up to three times per week. The 12 week follow up phase involved each participant completing three EMAs during weeks 4, 8, and 12.
Results: Four participants completed the intervention and follow-up phases. One participant withdrew during the intervention due to transient pain increases. EMA compliance rates were high and sufficient data were collected for the final analysis. Participant-1 did not improve. Participant-2 and -5 had reduced LBP intensity and pain interference, with large effect sizes (phi values of >1). Participant-4 experienced small to moderate reduction in LBP intensity and pain interference (phi values of 0.24 (0.16 to 0.58), p=0.2; and 0.7 (0.36 to 0.93), p<0.001).
Conclusions: GRM shows potential as an effective component of a massage therapy intervention for CLBP, with favourable effect on mean pain intensity of LBP locations, and pain interference, but may not be tolerated by all individuals. SCE design with data capture via online tools is a practical approach for evaluation of complex therapeutic interventions